When uncertain, does human self-motion decision-making fully utilize complete information?

When forced to choose humans often feel uncertain. Investigations of human perceptual decision-making often employ signal detection theory, which assumes that even when uncertain all available information is fully utilized. However, other studies have suggested or assumed that, when uncertain, human subjects guess totally at random, ignoring available information. When uncertain, do humans simply guess totally at random? Or do humans fully utilize complete information? Or does behavior fall between these two extremes yielding "above chance" performance without fully utilizing complete information? While it is often assumed complete information is fully utilized, even when uncertain, to our knowledge this has never been experimentally confirmed. To answer this question, we combined numerical simulations, theoretical analyses, and human studies performed using a self-motion direction-recognition perceptual decision-making task (did I rotate left or right?). Subjects were instructed to make forced-choice binary (left/right) and trinary (left/right/uncertain) decisions when cued following each stimulus. Our results show that humans 1) do not guess at random when uncertain and 2) make binary and trinary decisions equally well. These findings show that humans fully utilize complete information when uncertain for our perceptual decision-making task. This helps unify signal detection theory and other models of forced-choice decision-making which allow for uncertain responses. NEW & NOTEWORTHY Humans make many perceptual decisions every day. But what if we are uncertain? While many studies assume that humans fully utilize complete information, other studies have suggested and/or assumed that when we're uncertain and forced to decide, information is not fully utilized. While humans tend to perform above chance when uncertain, no earlier study has tested whether available information is fully utilized. Our results show that humans make fully informed decisions even when uncertain.

Corrigendum: Multivariate Analyses of Balance Test Performance, Vestibular Thresholds, and Age.

[This corrects the article DOI: 10.3389/fneur.2017.00578.].

Vestibular roll tilt thresholds partially mediate age-related effects on balance.

BACKGROUND: It has been well-established that both vestibular function and balance degrade with age and that balance degradation contributes to falls. While multiple causes contribute to balance declines, there have been few empirical investigations of the specific sensory contributors to balance that mediate (i.e., explain a significant fraction of) the effect of age on balance. OBJECTIVE: To determine if vestibular function significantly mediates the effect of age on balance, and to quantify the fraction of any such statistically significant age-effect on balance using previously published vestibular threshold and balance data. METHODS: Balance was quantified as complete/incomplete on a standard Romberg 4-condition foam balance test. Vestibular thresholds were determined using standard methods with motion provided by a Moog 6DOF motion platform. Standard mediation analyses were performed to determine if any of the five vestibular thresholds measured (0.2Hz roll tilt and 1Hz roll tilt, yaw rotation, y-translation, and z-translation) significantly mediated the previously reported age-effect on balance. RESULTS: 0.2Hz roll tilt thresholds were found to significantly mediate the relationship between age and balance, whether we considered all subjects or just the subjects above the age of 40 (above which vestibular thresholds increase with age). Depending on the exact age cut-off implemented between 37 and 42 years of age, 0.2Hz roll tilt thresholds explained (mediated) between 33% and 55% of the total age-effect on balance. CONCLUSION: Vestibular function may mediate approximately 50% of the widely-reported age-effect on balance. If confirmed by future studies, this may provide an opportunity to improve balance (and presumably reduce fall risk) via specific therapies tailored to improve vestibular function.

Detection of hearing loss in newborns: Definition of a screening strategy in Bogotá, Colombia.

OBJECTIVE: To describe the results from the hearing screening protocol adopted in a Hospital in Colombia emphasizing the importance of performing screening on an outpatient basis, when the newborn is more than 24 h old. METHODS: A prospective study at Hospital Universitario San Ignacio in Bogota, Colombia was carried out, from May 1st, 2016 to Nov 30th, 2017, the study sample included 2.088 newborns examined using transient otoacoustic emissions. RESULTS: We obtained written consent from the parents of 1.523 newborns and 24 individuals (1.6%) failed the first stage of the screening, nine cases unilateral and 15 bilateral. A total of nine neonates (0,6%) failed the second screening test, six cases unilateral and three bilateral. Four (0,3%) did not return to the second test. Our false altered screening rate was 0.7%. CONCLUSIONS: In a developing country with limited human and economic resources, in which newborn early discharge is the norm, a newborn hearing screening program linked to infants' check-ups, that uses otoacoustic emissions after 48 h of life, seems a feasible option compare to the standard US protocol aiming to conduct hearing screening prior to discharge.

Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience.

To better understand the various individual factors that contribute to balance and the relation to fall risk, we performed the modified Romberg Test of Standing Balance on Firm and Compliant Support, with 1,174 participants between 4 and 83 years of age. This research was conducted in the Living Laboratory® at the Museum of Science, Boston. We specifically focus on balance test condition 4, in which individuals stand on memory foam with eyes closed, and must rely on their vestibular system; therefore, performance in this balance test condition provides a proxy for vestibular function. We looked for balance variations associated with sex, race/ethnicity, health factors, and age. We found that balance test performance was stable between 10 and 39 years of age, with a slight increase in the failure rate for participants 4-9 years of age, suggesting a period of balance development in younger children. For participants 40 years and older, the balance test failure rate increased progressively with age. Diabetes and obesity are the two main health factors we found associated with poor balance, with test condition 4 failure rates of 57 and 19%, respectively. An increase in the odds of having fallen in the last year was associated with a decrease in the time to failure; once individuals dropped below a time to failure of 10 s, there was a significant 5.5-fold increase in the odds of having fallen in the last 12 months. These data alert us to screen for poor vestibular function in individuals 40 years and older or suffering from diabetes, in order to undertake the necessary diagnostic and rehabilitation measures, with a focus on reducing the morbidity and mortality of falls.

Multivariate Analyses of Balance Test Performance, Vestibular Thresholds, and Age.

We previously published vestibular perceptual thresholds and performance in the Modified Romberg Test of Standing Balance in 105 healthy humans ranging from ages 18 to 80 (1). Self-motion thresholds in the dark included roll tilt about an earth-horizontal axis at 0.2 and 1 Hz, yaw rotation about an earth-vertical axis at 1 Hz, y-translation (interaural/lateral) at 1 Hz, and z-translation (vertical) at 1 Hz. In this study, we focus on multiple variable analyses not reported in the earlier study. Specifically, we investigate correlations (1) among the five thresholds measured and (2) between thresholds, age, and the chance of failing condition 4 of the balance test, which increases vestibular reliance by having subjects stand on foam with eyes closed. We found moderate correlations (0.30-0.51) between vestibular thresholds for different motions, both before and after using our published aging regression to remove age effects. We found that lower or higher thresholds across all threshold measures are an individual trait that account for about 60% of the variation in the population. This can be further distributed into two components with about 20% of the variation explained by aging and 40% of variation explained by a single principal component that includes similar contributions from all threshold measures. When only roll tilt 0.2 Hz thresholds and age were analyzed together, we found that the chance of failing condition 4 depends significantly on both (p = 0.006 and p = 0.013, respectively). An analysis incorporating more variables found that the chance of failing condition 4 depended significantly only on roll tilt 0.2 Hz thresholds (p = 0.046) and not age (p = 0.10), sex nor any of the other four threshold measures, suggesting that some of the age effect might be captured by the fact that vestibular thresholds increase with age. For example, at 60 years of age, the chance of failing is roughly 5% for the lowest roll tilt thresholds in our population, but this increases to 80% for the highest roll tilt thresholds. These findings demonstrate the importance of roll tilt vestibular cues for balance, even in individuals reporting no vestibular symptoms and with no evidence of vestibular dysfunction.

Vestibular Perceptual Thresholds Increase above the Age of 40.

We measured vestibular perceptual thresholds in 105 healthy humans (54F/51M) ranging from 18 to 80 years of age. Direction-recognition thresholds were measured using standard methods. The motion consisted of single cycles of sinusoidal acceleration at 0.2 Hz for roll tilt and 1.0 Hz for yaw rotation about an earth-vertical axis, inter-aural earth-horizontal translation (y-translation), inferior-superior earth-vertical translation (z-translation), and roll tilt. A large subset of this population (99 of 105) also performed a modified Romberg test of standing balance. Despite the relatively large population (54F/51M), we found no difference between thresholds of male and female subjects. After pooling across sex, we found that thresholds increased above the age of 40 for all five motion directions investigated. The data were best modeled by a two-segment age model that yielded a constant baseline below an age cutoff of about 40 and a threshold increase above the age cutoff. For all subjects who passed all conditions of the balance test, the baseline thresholds were 0.97°/s for yaw rotation, 0.66°/s for 1-Hz roll tilt, 0.35°/s for 0.2-Hz roll tilt, 0.58 cm/s for y-translation, and 1.24 cm/s for z-translation. As a percentage of the baseline, the fitted slopes (indicating the threshold increase each decade above the age cutoff) were 83% for z-translation, 56% for 1-Hz roll tilt, 46% for y-translation, 32% for 0.2-Hz roll tilt, and 15% for yaw rotation. Even taking age and other factors into consideration, we found a significant correlation of balance test failures with increasing roll-tilt thresholds.

The importance of fundus eye testing in rubella-induced deafness.

OBJECTIVE: The purpose of this study was to establish a new approach to improve detection of deafness due to rubella. METHODS: Colombian institutes for the deaf were visited by a medical team to perform in all enrolled individuals an ophthalmological examination with emphasis in fundus eye by a retina specialist. In cases where ocular alterations compatible with CRS were found, a medical interview by a clinical geneticist analyzing pre-and postnatal history and a thorough medical examination was done. RESULTS: A total of 1383 deaf institutionalized individuals were evaluated in 9 Colombian cities in the period of 2005 to 2006, finding a total of 463 positive cases for salt-and-pepper retinopathy (33.5%), in which rubella could be the etiology of deafness. Medellin, Cartagena, Bucaramanga and Barranquilla were the cities with the highest percentage of Congenital rubella, corresponding to 22.8% of analyzed population. The analysis performed on cases in which reliable prenatal history was obtained in a second appointment (n=88) showed association between positive viral symptoms during pregnancy and salt-and-pepper retinopathy in 62.5% of cases, while both (retinopathy and viral symptoms) were absent in 29.5% of cases; showing a correlation in 92% of cases. CONCLUSIONS: The frequency of deafness by rubella obtained by this study is significantly high compared with previous Colombian studies and with international reports. It was possible to correlate the antecedent of symptoms during pregnancy with the presence of salt-and-pepper retinopathy in this deaf population when reliable prenatal history was available, therefore eye testing with emphasis in fundus examination is a good indicator of rubella induced deafness. We propose a new approach in the search of deafness causes, based on a thorough ophthalmologic examination in all deaf people.